Module 1: Healing After Debridement, Periodontal Re-Evaluation, Risk and Maintenance

What is the ideal form of healing?

Regeneration

What is the more predictable form of healing?

Repair via long junctional epithelium

What is long junctional epithelium?

Non-keratinized epithelium w/ fast tissue turnover

What are the principle wound healing events?

Early inflammation (neutrophils), late inflammation (macrophages), granulation tissue formation, matrix formation, remodelling.

Which bacteria are reduced after debridement?

P. gingivalis, A. actinomycetemcomitans, P. intermedia, T. Forsythia, T. denticola

What are the effects of poor oral hygiene after SRD?

Original microflora grows back, periodontal pockets won’t heal,

What are factors that affect complete debridement?

Access (probing depth, tooth type), root irregularities, instruments

When should you re-evaluate a gingivitis patient?

6 months

When should you re-evaluate a moderate periodontitis patient without systemic risk factors?

8-12 weeks

When should you re-evaluate a severe periodontitis patient with systemic risk factors?

6-8 weeks

What is the baseline exam process?

Review teeth, visual inspection of gingiva, review oral hygiene, repeat diagnostic tests

How much time does it take for a 4-6mm site to heal?

4-5 months with 2 recalls

How much time does it take for a 7+mm site to heal?

9-12 months with 3-4 recalls

What are the parameters for a stable periodontitis patient?

<10% BOP, <4mm PPD, no BOP at 4mm sites

What are the parameters for a periodontitis patient in remission?

>10% BOP, PPD <4mm, No BOP at 4mm sites